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This paper explores how the selection of peer researchers influences and shapes peer research projects. It draws on two empirical studies formed from two community action projects in England. Peer research is a method for involving young people as coresearchers within their community or in specific settings such as educational environments and the two projects recruited school children of different ages and ethnic backgrounds; in both cases they were representative of the potential participant population. One project (Community House) was based in a junior school setting and concentrated on evaluating a community centre project. The second project (Knife Angel: Hear My Voice) was a youth work setting and brought together a group of young people to explore an intervention aimed at impacting crime and violence in the local community. This paper discusses how the demographic characteristics of the peer researchers shaped, influenced and impacted the success of both community action projects. We discuss how children and young people bring their unique skills to preparing the questionnaire and dissemination. Using researcher reflexivity, we consider the methodological implications of the findings and contribute to theory building about community action and the impact of participatory research. [ABSTRACT FROM AUTHOR]

Lentigo maligna (LM) is a melanoma in situ with distinct clinical features and histology. It commonly affects men after the sixth decade of life. Incidence rates of LM have increased based on early 21st century data from different countries; however, data are suboptimal. Data from England show a plateauing crude incidence between 2013 and 2019. By comparison, invasive melanoma and other types of melanoma in situ commonly appears in younger age groups (median age 58 and 67 years old, respectively) and incidence is rising. The most important risk factors for LM include fair skin and cumulative ultraviolet solar radiation exposure. Although LM is limited to the epidermis and connected skin adnexa, it may progress to invasive LM melanoma. The reported rate of malignant progression varies, reflecting a challenge for LM epidemiology research as often lesions are removed on diagnosis. LM poses a challenge in diagnosis and management. Although it can be diagnosed clinically or dermoscopically, histopathological assessment of biopsied skin tissue remains the gold standard. Reflectance confocal microscopy allows for better appreciation of the complexity of LM at a cellular level, often progressing beyond clinical margins. Management of LM may involve Mohs micrographic surgery or excision, although recurrence may occur even with 5 mm clinical margins. Imiquimod cream may be effective, but incomplete treatment and recurrence has been reported. Conservative management with observation or radiotherapy may be used in selected patients' cases. Five-year net survival rates are excellent. This paper reviews the natural history, epidemiology, aetiology, pathogenesis, diagnosis and management of LM. [ABSTRACT FROM AUTHOR]

Frailty represents an integrative prognostic marker of risk that associates with a myriad of age-related adverse outcomes in older adults. As a concept, frailty can help to target scarce resources and identify subgroups of vulnerable older adults that may benefit from interventions or changes in medical management, such as pursing less aggressive glycaemic targets for frail older adults with diabetes. In practice, however, there are several operational challenges to implementing frailty screening outside the confines of geriatric medicine. Electronic frailty indices (eFIs) based on the theory of deficit accumulation, derived from routine data housed in the electronic health record, have emerged as a rapid, feasible and valid approach to screen for frailty at scale. The goal of this paper is to describe the early experience of three diverse groups in developing, implementing and adopting eFIs (The English National Health Service, US Department of Veterans Affairs and Atrium Health—Wake Forest Baptist). These groups span different countries and organisational complexity, using eFIs for both research and clinical care, and represent different levels of progress with clinical implementation. Using an implementation science framework, we describe common elements of successful implementation in these settings and set an agenda for future research and expansion of eFI-informed initiatives. [ABSTRACT FROM AUTHOR]

Record numbers of police officers are voluntarily resigning in England and Wales yet there is a lack of research which analyses why. Findings from an analysis of 62 interviews with police leavers who voluntarily resigned from the police service within England and Wales between January 2021 and June 2022 suggest that officers are leaving primarily due to perceptions of organizational injustice which focus upon: a lack of voice; concerns about promotion/progression; poor leadership; and a lack of organizational flexibility. This paper takes this latter reason—organizational flexibility—as its focus and through an inductive analysis of these leavers' voices, aims to both enrich the scarce qualitative academic literature on police workforce resignations and retention but also to offer significant evidence for future consideration of workforce optimization. The findings indicate that although sympathetic to operational policing complexities, participants were frustrated by organizational inflexibility. Three key areas were identified where the police service was perceived to be unsupportive or unreceptive—(a) dealing with additional needs, disabilities, or health issues of officers, (b) conflicts with non-work commitments, primarily those associated with childcare/parental responsibilities, and (c) supporting officers transitioning to part-time working. These structural barriers to effective workplace functioning were exacerbated by the cultural norms of overwork and 'fitting in' and were additionally particularly experienced by female resigners. The authors call for a challenge to the cultural barriers towards flexible working, the modelling of flexible working at all levels of the organization, and a focus on reciprocal flexibility between employer and employee. Until this issue can be tackled, it is argued that retention will continue to be an underestimated but significant site of inequality within policing. [ABSTRACT FROM AUTHOR]